Quick question about HIPPAA - am I right?

Discussion in 'The Watercooler' started by greenrene, Jan 9, 2013.

  1. greenrene

    greenrene Member

    UPDATE edit - sister in law said nevermind, she changed her mind about talking to the therapist. That was her last text - I haven't read the other ones and really don't want to...

    I posted in General about my sister in law offering to let difficult child stay with them for a little while. We are going back and forth about different logistics involved. I haven't even been able to have the discussion about it at ALL with my husband yet.

    I txted sister in law this morning about me trying to get an appointment to talk to difficult child's new therapist privately. As an aside on that, the receptionist told me that they usually don't do those kind of appointments, but she would talk to the therapist and get back with me on whether or not I could make the appointment. I mentioned the possibility of me talking to her (therapist) privately yesterday after difficult child's appointment, and she agreed.

    sister in law txted me, asking for the name and number of the therapist so SHE could make an appointment to talk to her. I told her that in all fairness, I needed to talk to husband about that first because he is the one who needs to be the decision maker about that. sister in law isn't happy about that, says that she isn't wanting to go in there to discuss difficult child, but she wanted to introduce herself and explain what their home life is like, etc and about the possibility of difficult child coming to stay with them. I told her that regardless of all that, and also regardless of her opinions about her brother's parenting skills, that he is still her father and he HAS to be the one to decide about this.

    She then said that she would just get the name from her mom. I fired back that doing that would be very much stepping over her boundaries, that it is ILLEGAL for the therapist to talk to her about anything to do with difficult child because it would be a HIPPAA violation unless husband gave specific permission. I think she was planning to get around the receptionist by just making an appointment with the therapist "for herself" and getting in that way. I still think that would end up being a HIPPAA violation...

    Thoughts? Am I right? I've just heard my phone chime like 6 times with txts from sister in law, and I really don't feel like getting into it with her about it. I just don't feel right giving her that info without talking to husband first. I will be happy to pass on the info once I've talked to him, but not before. Regardless I still think he would have to sign a form at the office beforehand.
    Last edited: Jan 9, 2013
  2. Signorina

    Signorina Guest

    It's not a HIPPAA violation for sister in law to SPEAK about anything or anyone to a physician.

    It's a violation if the physician SPEAKS to her about difficult child in specific terms based upon his direct knowledge of difficult child and difficult child's medical file.

    So - strictly HIPPAA speaking - the therapist can't talk about difficult child to your sister in law, but sister in law can talk about difficult child to the therapist. (provided the therapist accepts her for an appointment)
  3. greenrene

    greenrene Member

    Thank you for responding. It sounds like a slippery slope to me unless and until husband signs permission.
  4. greenrene

    greenrene Member

    And regardless, I am still uncomfortable about this until I talk to husband.
  5. witzend

    witzend Well-Known Member

    ^^ What Signora said about HIPAA.

    I think that I need to add that if you push this matter with the therapist, the HIPAA applies to her patient, which is your difficult child, not you and not your husband. While difficult child may have given her permission - or failed to deny her permission - to talk to you at this point, difficult child can take that privilege away, and unless she is threatening harm the therapist will back her on this. I'd do my best to not let difficult child have a CLUE that anyone is talking about her privilege with her therapist, because she's 15 years old and she'll take control of that situation in a heartbeat just because she can.

    I'm going to start with my advice for you because it is very important. Whatever you do, do NOT call the therapist office and make a stink about your sister in law, your privilege, or their confidentiality policy.

    As to your sister in law? Let her make a fool of herself. She's already passing that test with flying colors. Here's the only thing that the therapist is going to be "ok" right off the bat with:

    You, husband, sister in law, and possibly difficult child (or without difficult child but only with difficult child's knowledge) meet with therapist to attempt to come up with a plan of action for difficult child's immediate future that all parties can agree to. PERIOD.

    If sister in law calls and asks for an appointment to discuss her feelings on difficult child, what in the world makes her think that the scheduler is going to accommodate her when they won't accommodate you? I'd tell sister in law to go right ahead and try, and that she should be aware that she will be responsible for payment for any and all services she arranges or attends without your presence.

    If sister in law lies and makes an appointment for herself - which would be an intake appointment where they would first hand her a diagnostic test before she ever got into the room - if she could get past the test and into the room she'd find herself with a diagnosis of her own, and it wouldn't be something simple. I suspect that she'd be viewed as a Borderline Personality Disorder, or a Narcissistic Personality Disorder. People in good mental health do not ever lie their way into a therapist's office to discuss their life plan for their 15 year old niece to come live with them without the knowledge and/or consent of the parents. EVER. Worrying about what the therapist will say to her, or worrying that the therapist will think that she is anything other than selfish and deranged is a waste of your time and energy. Give yourself a big sigh of relief on that one right now and don't let it consume you.

    Don't argue, don't say anything in anger to anyone. These are the times that try the patience of every Warrior Mom. Put on your armor, and never let them see you sweat. All of this too, shall pass.
  6. greenrene

    greenrene Member

    Thank you, witzend. That is all very helpful

    As to me talking to the therapist - this came about yesterday. When the therapist brought difficult child out to the waiting room after her appointment, she asked me how Christmas break went. I hesitated a little and finally said that there were definitely some unpleasant situations that came about with difficult child. therapist looked surprised and said that she hadn't heard anything about that - of course she didn't, as difficult child would voluntarily tell on herself? I said that maybe I could come in to talk to her sometime soon and tell her about what happened, and the therapist said okay. I then called the office this morning, and the rest of the story is in my first post.

    I still haven't read the texts, and I got another one a few minutes ago. I'm going to talk to husband about giving her the info tonight if I can.
  7. witzend

    witzend Well-Known Member

    That makes sense about you and the therapist talking and then the receptionist not wanting to make an appointment for you. At that point it's about insurance. They have to have a diagnostic code to bill, and the diagnostic code they have is your daughter's. If it is only you in the office it's not treating her, and they have to bill that separately with you as patient and get insurance approval for you, etc...

    When we used to take the kids to the therapist if we wanted to talk alone we either had to go in with the kids and if the kids said it was ok we could take part of their allotted time to talk alone with the therapist, or make a separate appointment with ourselves as the patient and either bill insurance for us, or just pay out of pocket. The issue of our talking to any therapist regarding the kids during the kid's appointment was ALWAYS deferred to the kid.

    At the next therapist appointment, when they call difficult child into the room, look the therapist in the eye and say "I'd like to talk to you too. Can we do that now, or do you want to set up some time at the end of this appointment?" The therapist will ask difficult child and do what difficult child wants. We actually had a therapist who M had seen for years cut off the patient/therapist relationship with M because she felt that she needed to reveal something he said that concerned her against his wishes. So, she fired herself and told us right in front of him so he'd know what she said which was VERY vague. He did know that she was going to say it, though. We never did figure out what was going on, we had no right to know. It's probably best that we didn't because by then he was so far gone that knowing details wasn't going to help.
  8. DaisyFace

    DaisyFace Love me...Love me not


    We used to get around some of the issues by calling them "family therapy" appts. It allowed each family member to give the therapist their version of things first - and then we all went in together to discuss how to resolve things.

    I think Witzend has some great advice....and I do think that a "family therapy" session with sister in law included to help plan things is a good idea.
  9. witzend

    witzend Well-Known Member

    You have to be sure that your insurance covers "family therapy".
  10. buddy

    buddy New Member

    I thought they couldn't even acknowledge that anyone was a patient. So, if they even say I can listen to you but I can't tell you anything about.... that would break confidentiality because it says that the person is a client receiving services. I think they could probably say you can tell me whatever you want to but I can not confirm or deny that I have a patient by that name.

    I could be wrong, just remembering that I could get in big trouble unless a client specifically said that we were allowed to release that they were a patient in our clinic or hospital.
  11. witzend

    witzend Well-Known Member

    You're right about that. sister in law can make an appointment and talk about difficult child niece until she's blue in the face but she might as well be talking about the Pope. The sister in law would be treated as a separate patient talking about a separate family issue. Frankly, I'd be shocked if any therapist would make an appointment with her under the circumstances. That's why I brought up her making an appointment under false pretenses then changing the reason once she sees the therapist. It's the only way she'll get in to talk to that therapist about the niece without the niece's consent.